NPIMap

Organization Active NPI

Commonwealth of Virginia State Board of Health

Doing business as Botetourt County Health Department

  • Public Health or Welfare Agency
  • Fincastle, VA
National Provider Identifier
1104879568
Registry record updated Jul 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH
Doing business as
Botetourt County Health Department
Practice address
21 Academy Street
Fincastle, VA 24090-0220
Phone
(540) 473-8240
Fax
(540) 473-8242
NPI assigned
May 18, 2006
Last updated
Jul 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Vivian Penn-Timity
Title
Business Manager
Phone
(540) 204-9718

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

21 Academy Street
Fincastle, VA 24090-0220

Mailing address

PO Box 220
Fincastle, VA 24090-0220
Phone (540) 473-8240

Other identifiers 1

IdentifierTypeStateIssuer
4975324MedicaidVA

Other names 1

  • Botetourt County Health Department Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031117000414 VA Part B Supplier - Public Health/Welfare Agency 0547174369 Receives reassigned benefits from 6 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Bristol VA HLTH Departm163 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342742400000",
    "number": "1104879568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220",
            "city": "FINCASTLE",
            "state": "VA",
            "postal_code": "240900220",
            "telephone_number": "540-473-8240",
            "fax_number": "540-473-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 ACADEMY STREET",
            "city": "FINCASTLE",
            "state": "VA",
            "postal_code": "240900220",
            "telephone_number": "540-473-8240",
            "fax_number": "540-473-8242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH OF VIRGINIA STATE BOARD OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2012-07-20",
        "status": "A",
        "authorized_official_last_name": "PENN-TIMITY",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "540-204-9718",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4975324",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Botetourt County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fincastle, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.